{include file="public/header"/}
{include file="public/navleft" info=$info/}
    <div class="tpl-content-wrapper">
        <div class="tpl-content-page-title">
            医院详情 表单
        </div>
        <ol class="am-breadcrumb">
            <li><a href="#" class="am-icon-home">首页</a></li>
            <li><a href="#">表单</a></li>
            <li class="am-active">医院详情 表单</li>
        </ol>
        <div class="tpl-portlet-components">
            <div class="portlet-title">
                <div class="caption font-green bold">
                    <span class="am-icon-code"></span> 表单
                </div>
                <div class="tpl-portlet-input tpl-fz-ml">
                    <div class="portlet-input input-small input-inline">
                        <div class="input-icon right">
                            <i class="am-icon-search"></i>
                            <input type="text" class="form-control form-control-solid" placeholder="搜索..."> </div>
                    </div>
                </div>
            </div>
            <div class="tpl-block ">
                <div class="am-g tpl-amazeui-form">
                    <div class="am-u-sm-12 am-u-md-9">
                        <form class="am-form am-form-horizontal"  method="post" action="{:url('hospital/read')}">
                            <div class="am-form-group am-form-success am-form-icon am-form-feedback">
                                <label for="doc-ipt-3-a" class="am-u-sm-2 am-form-label">医院代号： / ID</label>
                                <div class="am-u-sm-10">
                                    <input type="text" id="doc-ipt-3-a"  name="dh" class="am-form-field" placeholder="输入医院代号">
                                    <span class="am-icon-warning"></span>
                                </div>
                            </div>
                            <div class="am-form-group">
                                <div class="am-u-sm-9 am-u-sm-push-6" style="left:35%">
                                    <button type="submit" class="am-btn am-btn-primary">点击查询</button>
                                    <button type="button" class="am-btn am-btn-primary" onclick="hospital.del()">点击删除</button>
                                    <button type="button" class="am-btn am-btn-primary" onclick="hospital.sign()">增加签章并生成最近七天</button>
                                </div>
                            </div>
                        </form>

                        <div class="am-g" style="margin-left: 17%">
                            <div class="am-u-md-8 am-u-sm-centered" >
                                <form class="am-form"  method="post" action="{:url('hospital/updateHospital')}">
                                     <fieldset class="am-form-set ">
                                        <input type="text" placeholder="医院代号" name="ybid" value="{$data.dh|default=''}" readonly  unselectable="on"  >
                                        <input type="text" placeholder="医院名称" name="mc" value="{$data.mc|default=''}">
                                        <input type="text" placeholder="登录密码" name="pwd" value="{$data.password|default=''}">
                                         <input type="text" placeholder="是否禁用-启用'0'  禁用'1' ** WeChat_Users IsDisable " name="IsDisable" value="{$data.IsDisable|default=''}">
                                         <input type="text"  placeholder="电子签章-没有'0' 存在'1'" name="sign" value="{$data.sign|default=''}" >

                                         <select name="sfjb" lay-verify="">
                                             <option value="1" {empty name="$data"}{else /}{if  $data.sfjb==1} selected="selected" {/if}{/empty}>一级收费**收费级别</option>
                                             <option value="2" {empty name="$data"}{else /}{if  $data.sfjb==2}  selected="selected" {/if}{/empty}>二级收费**收费级别</option>
                                             <option value="3" {empty name="$data"}{else /}{if  $data.sfjb==3}  selected="selected" {/if}{/empty}>三级收费**收费级别</option>
                                             <option value="4" {empty name="$data"}{else /}{if  $data.sfjb==4}  selected="selected" {/if}{/empty}>四级收费**收费级别</option>
                                         </select>

                                         <select name="beizhu" lay-verify="">
                                             <option value="1" {empty name="$data"}{else /}{if  $data.beizhu==1} selected="selected" {/if}{/empty}>公立医院**医院性质</option>
                                             <option value="2" {empty name="$data"}{else /}{if  $data.beizhu==2}  selected="selected" {/if}{/empty}>民营医院**医院性质</option>
                                             <option value="3" {empty name="$data"}{else /}{if  $data.beizhu==3}  selected="selected" {/if}{/empty}>体检机构**医院性质</option>
                                             <option value="4" {empty name="$data"}{else /}{if  $data.beizhu==4}  selected="selected" {/if}{/empty}>其他**医院性质</option>
                                         </select>


                                         <!--         <input type="text" placeholder="是否配置报告章&#45;&#45;'是' or '否'">
                                                &lt;!&ndash;  <select multiple data-am-selected  >
                                                      <option value="a">Apple</option>
                                                      <option value="b" selected>Banana</option>

                                                  </select>&ndash;&gt;
                                                  <input type="text" placeholder="业务员">
                                                  <input type="text" placeholder="业务经理">
                                                  <input type="email" placeholder="报告抬头">-->


                                    <button type="submit" class="am-btn am-btn-primary am-btn-block">确认修改</button>
                                         </fieldset>
                                </form>
                            </div>
                        </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>

        </div>


    </div>

</div>

{include file="public/footer"/}
